One RPM expert's take on why the tech is needed alongside telehealth

The CEO of remote patient monitoring company Vivify Health talks how RPM, virtual care and analytics can improve outcomes and better move providers toward value-based care.
By Bill Siwicki
10:30 AM

Eric Rock, CEO, Vivify Health

Photo: Vivify Health

As the COVID-19 pandemic struck in early 2020, healthcare provider organizations across the country began implementing telehealth technologies and services en masse. Telemedicine finally made it to the mainstream.

But only a subset of that group of providers implemented remote patient monitoring. Like telehealth, RPM can really improve care, gain efficiencies and trim costs. And RPM provides visibility outside of the actual patient encounter.

Eric Rock is CEO of remote patient monitoring company Vivify Health. He sat down with Healthcare IT News to discuss how telehealth and RPM can work together, the role analytics plays with RPM and the future of RPM.

Q. You've suggested that many healthcare provider organizations have been shortsighted during the pandemic, only implementing telehealth when they really needed remote patient monitoring, too. Please elaborate.

A. Early on in the pandemic, the Centers for Medicare & Medicaid Services (CMS) extended telehealth waivers that helped bring virtual care services into the mainstream. Unfortunately, when the pandemic subsides, it's likely those waivers will go away.

From that point forward, all health systems will need to have a HIPAA-compliant solution at the ready. There is a reason health systems aligned with Teladoc and AmWell, among other virtual care services, during the pandemic: They needed to establish secure and functional products for their patient populations while in-person care was suspended.

Though it was important to ensure the telehealth infrastructure was in place for patients to receive timely care, we need to help refocus the forward-looking efforts for health systems in the telehealth space. Originally, delivering episodic care was the focal point, but now we need to shift our thinking to providing continual care.

The reason why is twofold: It's the right thing to do for our patients, and it helps avoid costly readmission penalties. There are clinical and financial considerations behind embracing a longer lens on care.

We must enable technology to allow health systems to have a continual relationship with their patients; the care journey doesn't simply end when they leave the hospital. For many, they require constant treatment, which is where the advent of remote patient monitoring becomes a useful asset.

If telehealth was getting technology's foot in the door as it relates to patient care, RPM extends the leg and then the entire body into the home. We can be even better stewards of our patients' health if we supply them with the right tools to remain connected.

We've seen this happen already in the behavioral health space, which has relied heavily on virtual care services throughout the pandemic as people dealt with loneliness and isolation.

Instead of only being available when people were experiencing instances of acute depression and vulnerability, virtual behavioral health allowed health systems to always be there for patients in need. We have the technology in our arsenal to offer our patients sufficient remedies; we just need to move the ball down the field on these projects.

Q. Is telehealth alone transformative enough to handle the evolving needs of hospitals and health systems?

A. No, telehealth alone is not enough. Telehealth is a start, and an important component for hospitals in an increasingly technology-based world. But RPM is another important consideration for health systems.

The one true path for health systems is value-based models, so these organizations should be preparing for them now, securing available reimbursements and establishing relationships with payers that are willing to leverage their size for quality. From a fiscal perspective, at a minimum, I recommend that health systems apply RPM where reimbursements exist today or where there are potential penalties.

Additionally, hospitals are dealing with fluid changes to the broader healthcare landscape and require solutions that are dynamic in nature. As these organizations move into a space more focused on delivering continual care, there will need to be a more convenient, direct-to-consumer relationship.

One Vivify client, Banyan Community Health Center in South Florida, received a special grant of nearly $1 million from the Federal Communications Commission to fund its telehealth and RPM programs.

On a two-week timeline, Banyan launched its intensive telehealth unit (ITU) and RPM program, to potentially serve 2,000 patients in the Miami-Dade area using seven clinical pathways: virtual visits with biometrics, hypertension, depression, COVID-19, substance use, anxiety and diabetes.

Notably, the ITU program had few hospital admissions and zero readmissions between November 2020 and June 2021, while ER visits per 1,000 patients in ITU have remained close to zero most months and are 90% lower than the overall population.

Building that trust with patients will keep them using virtual care products and going back when they need treatment. For true patient engagement, organizations need to not only treat them in times of need but also collect enough data over time to analyze their conditions.

Q. What role does analytics play with telehealth and remote patient monitoring when it comes to truly transforming healthcare practices?

A. Artificial intelligence and clinical decision support are two things that everyone in healthcare should be moving toward.

Analytics, as is its nature, can provide an instant guide to a patient's status for the clinical staff using telehealth or RPM programs. Basic analytics, such as a daily health score, can assist health systems in terms of prioritizing and triaging patients throughout the day. Analytics also can graph the data in a way that visualizes the information for the clinical staff.

This is a first-of-its-kind effort to gather daily information and make it actionable for those on the clinical side of the operation. This approach applies information in a way that makes a difference in terms of cost and outcomes. It promotes management by exception, meaning patients don't have to come back to a clinic for an appointment. That visit can be handled virtually and in a quicker way than the traditional in-person visit at a hospital.

Finally, using this type of data allows for health systems to become more predictive in their approach to patient care due to the information they have collected and analyzed. For everyone in digital health, as we apply new technologies, we will have transformed healthcare through analytics.

Q. If we were to have a conversation three to five years from now, where do you think the industry will be?

A. The next generation of healthcare delivery, much like the existing EHRs are today for episodic encounters, will have tool sets that allow you to capture all of the codes necessary for the procedures that you're applying.

The future of healthcare is measured by your outcomes, your role and the amount of time spent. That is an amalgamation of telehealth, RPM, clinical documentation surveillance and analytics tools in a way that will position you to be reimbursed. Then you can practice at the top of your license again without being in a documentation nightmare and so focused on CPT codes that you can't see straight.

Let the tools themselves do the work so you can focus on delivering care.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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